Maintaining the Therapeutic Alliance When Reporting Child Maltreatment: Recommendations for Mental Health Clinicians

摘要

Child maltreatment is a significant public health issue often resulting in long-term physical and mental health difficulties among the affected youth. The first steps in promoting child safety require the accurate identification and prompt reporting of suspected child maltreatment. However, mandated reporters, including mental health clinicians, often struggle to know how to identify and when to report child maltreatment, especially due to concerns that a report will disrupt or end the therapeutic alliance, a core component of the therapeutic process that is strongly related to successful psychotherapy outcomes. To address mental health clinicians' concerns, the current review modifies the "SPIKES" protocol (which includes steps for confronting Setting, Perception, Invitation, Knowledge, Emotion, Strategy, and Summary), originally developed for breaking "bad news" in oncology. The current review aims to provide recommendations on how mental health clinicians can report child maltreatment through a collaborative and supportive approach with parents while focusing on maintaining the therapeutic alliance.